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nurs 345: children > ch 29: communication & physical assessment > Flashcards

ch 29: communication & physical assessment Flashcards

EXAM 1 content

1
Q

before even starting the interview, what should you do?

A

establish a setting
- introduction
- assure privacy & confidentiality

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2
Q

how should you communicate with families?

A
  • encourage them to talk to their kid & what they want
  • direct focus
  • listen & cultural awareness
  • using silence
  • empathy
  • guidance
  • avoid blocks of communication
  • use an interpreter if needed
  • talk about the different developmental processes
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3
Q

what should you as the nurse control about yourself?

A

know your weaknesses
- control your face
- dont be overwhelming
- self awareness

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4
Q

what are some communication techniques?

A
  • verbal & non verbal
  • play
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5
Q

how should you take history?

A
  • identify info
  • know the chief complaint
  • if there is a present illness –> OLD CARTS
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6
Q

what should you jot down when taking past medical history for the child?

A
  • birth hx
  • any previous illness, injuries & operations
  • allergies
  • current medications
  • immunizations
  • diet hx
  • habits
  • growth & development!!
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7
Q

how should you approach the interview? what is important before asking questions?

A
  • explain what you are doing
  • let them get comfortable
  • ask open ended questions
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8
Q

how do you make an infant comfortable for the interview?

A

ask questions to the parents first, let the infant get used to their environment

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9
Q

how do you let a preschooler get comfortable before the interview?

A

play with them first

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10
Q

how do you let an adolescent get comfortable?

A

talk to them right away

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11
Q

what is the process of the interview (in steps)?

A
  1. introduce yourself
  2. get to know them
  3. explain what you are doing
  4. ask about what they are here for (if pain –> OLD CARTS)
  5. neuro
  6. cardiovascular
  7. respiratory
  8. GI
  9. GU
  10. musculoskeletal
  11. skin
  12. sexual history & more private questions
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12
Q

after assessing the skin in the interview, how old should the patient be to know if you want to ask about sexual history?

A

13 years old

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13
Q

what should you do before asking about more personal questions and their sexual history?

A

ask the parents to step out of the room

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14
Q

what are the interviewing steps for sexual history & more private questions?

A
  1. ask the parent to step out
  2. explain that the information is confidential except for suicide & homicide
  3. aks about depression, anxiety & suicide
  4. ask about intercourse
  5. sexual orientation
  6. ask if they have a trusted adult they can go to
  7. education
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15
Q

what should you jot down for family health history?

A
  • geographic location: can understand different diseases based on loco
  • family structure
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16
Q

what should you assess for nutrition in the child?

A
  • diet intake
  • hair, skin, mouth, & eyes
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17
Q

what are the results/evaluation choices after assessing the nutrition of the child?

A
  • malnourished
  • at risk
  • well nourished
  • overweight or obese
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18
Q

what are some challenges to examining a child?

A

they can be reluctant & have trantrums

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19
Q

how should we approach examining of the child?

A

most comfortable first –> least comfortable last

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20
Q

what is the most uncomfortable to children?

A

eyes, ears & mouth

21
Q

what are the goals to a pediatric assessment?

A
  • minimize stress & anxiety
  • foster trust
  • maximum preparation
  • preserve security of parent & child
  • maximize accuracy
22
Q

what are the assessment goals of an infant?

A

make these a priority when they are calm
- RR
- HR
- bowel sounds

23
Q

how should we prepare a child for an assessment?

A
  • cooperation enhanced with parents
  • age appropriate techniques
  • positioning
24
Q

what are some age appropriate techniques?

A
  • dolls & teddy bears
  • parents present
  • videos
  • demonstration
25
what is prioritized in a physical exam?
growth measurements - length - height - weight circumference measures - skin thickness - arm circumference - head circumference
26
how should we approach the physical exam in school age kids?
make it like a game -- they want to see how strong they are
27
how do growth curves track development of a child?
the body grows during homeostasis - if child is dropping off --> a sign that something is wrong - endocrine or medical problems
28
what should we jot down for physiological measurements and what goes first?
respiratory is always first then - temperature - pulse: radial, brachial, or apical
29
what area is prefered to get a pulse on a child?
apical
30
how long should you count for RR & HR and why?
60 seconds -- to get a full accurate count
31
where are areas can you put the BP cuff?
- brachial artery - radial artery - popliteal artery - dorsalis pedis artery - posterior tibial artery
32
when do posterior cranial sutures close for infants?
2 months
33
when do anterior cranial sutures close for infants?
12-18 months
34
do we always assess the cranial nerves?
no, only for specific neuro exams
35
what is the eye chart called for younger kids?
allen figures chart
36
why aren't we really worried ab an infant's vision?
- can only see mom's face -- they should be able to follow mom's face with their eyes - vision is still developing
36
when assessing the internal structures of the ear, what age do we pull the pinna down and back?
less than 2 years old
36
when assessing the internal structures of the ear, what age do we pull the pinna up and back?
2 yo and older
36
what should we assess about the nose?
- sides - nares - patency - any drainage - how does it fit with the rest of their face?
36
what should we be aware about the chest?
one side can be lower then the other
37
what is something we need to get used to when auscultating the lungs?
hearing the heart & lungs simultaneously
38
Should we worry about heart murmurs when we heart them in kids?
not really, some kids grow out of it
39
how should we auscultate the heart?
APE To Man
40
what should we look out for when assessing genitalia?
swelling
41
what should we look out for when assessing the anus?
- patency - are they pooping?
42
describe genu valgum
when the kids knees are stuck together like gum
43
describe genu varum
when the knees are spread apart like a bottle of rum is between them
44
which is more normal, genu valgum or genu varum?
genu varum, "bow leg"
45
when is genu valgum and genu varum considered a problem?
when their legs are still like that by the age of 2yo +

nurs 345: children (23 decks)

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